Efficacy of Repetitive Transcranial Magnetic Stimulation for Improving Depressive Symptoms in Patients With Parkinson's Disease

Exclusion Criteria

• •History of epilepsy
• •Parkinson's disease caused by cerebrovascular disease, CNS infection, intoxication, or traumatic brain injury
• •Diagnosed with Parkinson-plus syndromes (multiple system atrophy, progressive supranuclear palsy, corticobasal degeneration, dementia with Lewy bodies etc.)
• •Clinically significant abnormal laboratory values (AST, ALT, or total bilirubin \> 2.5 x ULN)
• •Diagnosed with psychiatric disorders
• •Unable to follow instructions or communicate
• •Pregnant, breastfeeding, or women of childbearing potential
• •Febrile patients
• •Patients with artificial hip joint implants
• •Presence of conductive, ferromagnetic, or magnetically sensitive metal near the head or treatment coil (e.g., cochlear implants, implanted electrodes/stimulators, aneurysm clips or coils)
• •Cardiac disease, especially patients with pacemakers
• •Corrected or uncorrected visual acuity less than 0.5
• •Use of drug infusion pumps or hearing aids
• •Patients with acute illness
• •Patients taking tricyclic antidepressants, neuroleptics, or other medications that may lower seizure threshold
• •History of increased intracranial pressure or head trauma
• •Evidence of external wounds on brain or neck
• •Prominent psychotic symptoms other than depression (high NPI scores for hallucinations, delusions, mania)
• •History of schizophrenia, bipolar disorder, or substance abuse
• •Suicidal ideation (BDI-II item 9 score of 2 or 3)
• •History of or planned deep brain stimulation or stereotactic surgery (pallidotomy, thalamotomy)
• •Any participant deemed ineligible by the investigator, including those with medical conditions that may increase risk or interfere with study evaluation
• •Currently enrolled in another clinical trial or used investigational drug/device within 30 days or 5 half-lives prior to consent